Clinico-etiological profile of children with seizures at a tertiary care centre in rural area in North India with special emphasis on “treatment gap”: a retrospective observational study

Abstract

Background: Childhood seizures are common neurological disorder. There is paucity of studies on etiology of seizures with revised standard definitions and of studies highlighting the treatment gap, required to plan health care services in rural areas of developing countries with limited resources. Objectives were to study the clinical and etiological profile of children with seizures and treatment gap in outpatient department of tertiary care centre in rural area in Northern India.Methods: It was a retrospective observational study in which relevant data on clinical, etiological profile and treatment details collected from OPD records was analyzed,Results: Study population of 249 children with mean age 9.2 (4.6) years and 52% females was analyzed. Generalized seizure was most frequent seizure type (71.50%). Neurocysticercosis was most common etiology (45.8%). Neuroimaging was abnormal in 79% cases. There was treatment gap of 66% with 43% children not started on any antiepileptic drug. The 58% children were taken to local tantriks believing that seizure is due to evil spirit. Amongst children who were given antiepileptic drugs (AEDs) (n=142), 86.6% were on monotherapy of which carbamazepine was most frequently prescribed drug (41%).Conclusions: The results of study would help to streamline the limited resources available for treatment and prevention of childhood seizures in the rural community and conduct socio culturally acceptable health campaigns to educate people about seizure and bridge the treatment gap.